On Tuesday, February 12, President Obama gave the first State of the Union of his second term. The only thing about the speech that both parties could agree on was that it was historic. Republicans called it a historic partisan embrace of liberalism, while Democrats praised the President for his bold vision. Yet little media attention has been given to President Obama’s boldest claim, his claim that we can create an AIDS-free generation in our lifetime. This would be an achievement on par with the eradication of small pox[1] and would save the 1.6 million people who die globally each year as a result of HIV/AIDS.

In order to achieve this goal, more domestic funding is necessary to identify those with the disease and to get them into treatment. We have the medical tools available to relegate HIV to the history books, if Washington takes action by increasing the funding for the Ryan White Care Act when it comes up for reauthorization later this year. The funding for Ryan White has remained almost constant at approximately $2 billion over the past decade, even though the number of infected Americans has increased by 500,000 over that same span.

When HIV was first documented in the 1980s it was viewed as a gay man’s disease, a supposed consequence of a decadent and wild lifestyle. Within a few years, injection drug users were added to the list of those at risk for HIV. This characterization as a disease that individuals caught due to perceived vices led to tremendous stigma that left those infected with little social or political support.

President Obama would not have been able to make his bold claim without the impressive scientific gains made following the discovery of HIV. In 1986, the FDA approved zidovudine (AZT) as the first medication to treat HIV. However, the harshness of the medication meant that for most patients the treatment was effectively a death sentence. AZT required patients to take a dozen pills under very strict conditions. In the context of HIV and AIDS medication, the ‘80s were a time of great despair.

In stark contrast the ‘90s saw advancements in the public perception and treatment of HIV that culminated in the President’s speech. The 90’s saw the advent of protease inhibitors and combination therapies[2] that controlled the spread of the virus and studies proved that HIV medication drastically reduced the likelihood of transmission of the disease from mother to child. The 2000s have seen continued advancements like FDA approval for human testing of an HIV vaccine, the sale of the first in-home HIV test, and the creation of one a day HIV medications. The advancements of the ‘90s combined with the emergence of advocacy organizations like ACT UP and several high profile disclosures helped bring HIV into the public forum.

Two of the most important HIV disclosures in terms of combating stigma were those of Ryan White and Magic Johnson. Ryan White contracted HIV at the age of 13 after he received tainted blood as part of his hemophilia treatment. As a young, white, heterosexual boy from the Midwest, Ryan did not fit the generally accepted image of someone with HIV. His was certainly not a disease of vice. Ryan spent his final days educating people on HIV and its transmission. In November of 1991, a year after Ryan’s death, Magic Johnson disclosed his HIV status. Like Ryan, Magic Johnson’s diagnosis refuted the common HIV stereotype. Magic Johnson’s life has helped to show the world that HIV is not a death sentence and the path to creating an AIDS-free generation.

On June 4, 1992, Magic Johnson and his wife celebrated the birth of their son, Earvin Johnson III. Both mother and child were given a clean bill of health even though HIV is a sexually transmitted disease. This astounding outcome was achieved primarily because Magic adhered to his HIV treatment. Results from a study conducted by the National Institute of Health (NIH) showed that adherence to HIV medication led to a 96% reduction in the risk of transmitting HIV. This incredible statistic alone could be enough to create the AIDS-free generation, but it is not the only tool we have at our disposal.

The Center for Disease Control estimates that 40-60 percent of HIV infected individuals do not know their HIV status. These individuals are responsible for the vast majority of new HIV infections. If we can get these individuals in treatment, we can save their lives and prevent the spread of HIV. With increased funding and a focus on identification and retention in treatment, we can drastically reduce the number of new infections, and over time eradicate HIV/AIDS. This increased funding would need to be accompanied by public education campaigns to not only spread the word but to combat the stigma surrounding HIV. The eradication of HIV would be a historic achievement that all Americans, regardless of their political views, could be proud of.

– Post by Solomon Banjo, MPP ‘13

[1] In 1967 15 million people were infected with smallpox, a decade later that number was 0.

[2] These therapies drastically reduced the number of pills taken and were a precursor to one a day treatments.